Acta bioquímica clínica latinoamericana
versión On-line ISSN 1851-6114
BARRAL, María. Integrated management and the dynamic of systems: Criteria to be applied to clinical laboratories. Acta bioquím. clín. latinoam. [online]. 2007, vol.41, n.3, pp. 407-418. ISSN 1851-6114.
It is recognized that in order to manage some health services in which Clinical Laboratories are included, some criteria derived from the hard sciences are at the same time applied, as observed in the scientific and operative planning and other criteria from the social sciences, like the ones used for staff or economic-administrative management. When the quality of these services is managed, the so called organized complexity that supposes the existence of explicit mechanisms, in work activities like the ones posed by Shewart-Deming, and other implicit ones, like those that confer a systemic character to management, comes up. The same type of management by processes is present in both models, where the resources are included in an entry or input and where the exit or output is the consequence of the work done through transformation processes. The service or result value is set by the interface among processes and by the feedback generated, this understood as the control plus communication that allow, among other things, to balance the system, to later correct it, in some cases to improve it, and in other few cases to innovate it. Both approaches are complementary and some national and international regulations that refer to quality systems and integrated system managements (SIG) are based on them. These criteria, modeled or not, link the Laboratory as an open system considering its many internal and external interests, and enable a strategic planning and replanning as the core of the management. In this case, an example of the interfaces generated among the quality, environment, and occupational safety and health systems is shown. The way the recognition of the systemic mechanism influences the management of integrated systems (SIG) applied to the Clinical Laboratory is discussed.
Palabras clave : integrated systems management; general systems theory; system and organization; feedback and control; planning and replanning.